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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Architectural distortion (AD)
Synonyms
- Puckering; "tent" sign
Definitions
- Distorted breast parenchyma without discernible mass
- May be associated with mass, asymmetry, Ca⁺⁺
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Contrast-Enhanced Mammography
Image-Guided Biopsy
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Alshafeiy TI et al: Outcome of architectural distortion detected only at breast tomosynthesis versus 2D mammography. Radiology. 288(1):38-46, 2018
- Nakhlis F et al: Complex sclerosing lesions and radial sclerosing lesions on core needle biopsy: Low risk of carcinoma on excision in cases with clinical and imaging concordance. Breast J. 24(2):133-8, 2018
- Niell BL et al: Utility of breast MRI for further evaluation of equivocal findings on digital breast tomosynthesis. AJR Am J Roentgenol. 211(5):1171-8, 2018
- Patel BK et al: Initial experience of tomosynthesis-guided vacuum-assisted biopsies of tomosynthesis-detected (2D mammography and ultrasound occult) architectural distortions. AJR Am J Roentgenol. 210(6):1395-400, 2018
- Vijapura C et al: Imaging features of nonmalignant and malignant architectural distortion detected by tomosynthesis. AJR Am J Roentgenol. 211(6):1397-404, 2018
- Bahl M et al: Pathologic outcomes of architectural distortion on digital 2D versus tomosynthesis mammography. AJR Am J Roentgenol. 209(5):1162-7, 2017
- Cohen MA et al: Radial scars of the breast encountered at core biopsy: Review of histologic, imaging, and management considerations. AJR Am J Roentgenol. 209(5):1168-77, 2017
- Patel BK et al: Clinical utility of contrast-enhanced spectral mammography as an adjunct for tomosynthesis-detected architectural distortion. Clin Imaging. 46:44-52, 2017
- Durand MA et al: Tomosynthesis-detected architectural distortion: Management algorithm with radiologic-pathologic correlation. Radiographics. 36(2):311-21, 2016
- Bahl M et al: Architectural distortion on mammography: Correlation with pathologic outcomes and predictors of malignancy. AJR Am J Roentgenol. 205(6):1339-45, 2015
- Freer PE et al: Preoperative tomosynthesis-guided needle localization of mammographically and sonographically occult breast lesions. Radiology. 275(2):377-83, 2015
- Lourenco AP et al: Changes in recall type and patient treatment following implementation of screening digital breast tomosynthesis. Radiology. 274(2):337-42, 2015
- Ray KM et al: Suspicious findings at digital breast tomosynthesis occult to conventional digital mammography: Imaging Features and Pathology Findings. Breast J. 21(5):538-42, 2015
- Partyka L et al: Detection of mammographically occult architectural distortion on digital breast tomosynthesis screening: initial clinical experience. AJR Am J Roentgenol. 203(1):216-22, 2014
- Mendelson EB et al: Breast Imaging Reporting and Data System: BI-RADS, Ultrasound. 2nd ed. Reston: American College of Radiology, 2013
- Sickles EA et al: Breast Imaging Reporting and Data System: BI-RADS, Mammography. 5th ed. Reston: American College of Radiology, 2013
- Chansakul T et al: The postconservation breast: part 1, Expected imaging findings. AJR Am J Roentgenol. 198(2):321-30, 2012
- Chansakul T et al: The postconservation breast: part 2, Imaging findings of tumor recurrence and other long-term sequelae. AJR Am J Roentgenol. 198(2):331-43, 2012
- Gruber R et al: Histologic work-up of non-palpable breast lesions classified as probably benign at initial mammography and/or ultrasound (BI-RADS category 3). Eur J Radiol. Epub ahead of print, 2012
- Londero V et al: High-risk breast lesions at imaging-guided needle biopsy: usefulness of MRI for treatment decision. AJR Am J Roentgenol. 199(2):W240-50, 2012
- Shaheen R et al: Spectrum of diseases presenting as architectural distortion on mammography: multimodality radiologic imaging with pathologic correlation. Semin Ultrasound CT MR. 32(4):351-62, 2011
- Pediconi F et al: Role of breast MR imaging for predicting malignancy of histologically borderline lesions diagnosed at core needle biopsy: prospective evaluation. Radiology. 257(3):653-61, 2010
- Venkatesan A et al: Positive predictive value of specific mammographic findings according to reader and patient variables. Radiology. 250(3):648-57, 2009
- Günhan-Bilgen I et al: Tubular carcinoma of the breast: mammographic, sonographic, clinical and pathologic findings. Eur J Radiol. 61(1):158-62, 2007
- Cawson JN: Can sonography be used to help differentiate between radial scars and breast cancers? Breast. 14(5):352-9, 2005
- Pediconi F et al: Radial scars of the breast: contrast-enhanced magnetic resonance mammography appearance. Breast J. 11(1):23-8, 2005
- Baker JA et al: Computer-aided detection (CAD) in screening mammography: sensitivity of commercial CAD systems for detecting architectural distortion. AJR Am J Roentgenol. 181(4):1083-8, 2003
- Brenner RJ et al: Percutaneous core needle biopsy of radial scars of the breast: when is excision necessary? AJR Am J Roentgenol. 179(5):1179-84, 2002
- Gajdos C et al: Mammographic appearance of nonpalpable breast cancer reflects pathologic characteristics. Ann Surg. 235(2):246-51, 2002
- Krishnamurthy R et al: Mammographic findings after breast conservation therapy. Radiographics. 19 Spec No:S53-62; quiz S262-3, 1999
- Venta LA et al: Imaging features of focal breast fibrosis: mammographic-pathologic correlation of noncalcified breast lesions. AJR Am J Roentgenol. 173(2):309-16, 1999
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Architectural distortion (AD)
Synonyms
- Puckering; "tent" sign
Definitions
- Distorted breast parenchyma without discernible mass
- May be associated with mass, asymmetry, Ca⁺⁺
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Contrast-Enhanced Mammography
Image-Guided Biopsy
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Alshafeiy TI et al: Outcome of architectural distortion detected only at breast tomosynthesis versus 2D mammography. Radiology. 288(1):38-46, 2018
- Nakhlis F et al: Complex sclerosing lesions and radial sclerosing lesions on core needle biopsy: Low risk of carcinoma on excision in cases with clinical and imaging concordance. Breast J. 24(2):133-8, 2018
- Niell BL et al: Utility of breast MRI for further evaluation of equivocal findings on digital breast tomosynthesis. AJR Am J Roentgenol. 211(5):1171-8, 2018
- Patel BK et al: Initial experience of tomosynthesis-guided vacuum-assisted biopsies of tomosynthesis-detected (2D mammography and ultrasound occult) architectural distortions. AJR Am J Roentgenol. 210(6):1395-400, 2018
- Vijapura C et al: Imaging features of nonmalignant and malignant architectural distortion detected by tomosynthesis. AJR Am J Roentgenol. 211(6):1397-404, 2018
- Bahl M et al: Pathologic outcomes of architectural distortion on digital 2D versus tomosynthesis mammography. AJR Am J Roentgenol. 209(5):1162-7, 2017
- Cohen MA et al: Radial scars of the breast encountered at core biopsy: Review of histologic, imaging, and management considerations. AJR Am J Roentgenol. 209(5):1168-77, 2017
- Patel BK et al: Clinical utility of contrast-enhanced spectral mammography as an adjunct for tomosynthesis-detected architectural distortion. Clin Imaging. 46:44-52, 2017
- Durand MA et al: Tomosynthesis-detected architectural distortion: Management algorithm with radiologic-pathologic correlation. Radiographics. 36(2):311-21, 2016
- Bahl M et al: Architectural distortion on mammography: Correlation with pathologic outcomes and predictors of malignancy. AJR Am J Roentgenol. 205(6):1339-45, 2015
- Freer PE et al: Preoperative tomosynthesis-guided needle localization of mammographically and sonographically occult breast lesions. Radiology. 275(2):377-83, 2015
- Lourenco AP et al: Changes in recall type and patient treatment following implementation of screening digital breast tomosynthesis. Radiology. 274(2):337-42, 2015
- Ray KM et al: Suspicious findings at digital breast tomosynthesis occult to conventional digital mammography: Imaging Features and Pathology Findings. Breast J. 21(5):538-42, 2015
- Partyka L et al: Detection of mammographically occult architectural distortion on digital breast tomosynthesis screening: initial clinical experience. AJR Am J Roentgenol. 203(1):216-22, 2014
- Mendelson EB et al: Breast Imaging Reporting and Data System: BI-RADS, Ultrasound. 2nd ed. Reston: American College of Radiology, 2013
- Sickles EA et al: Breast Imaging Reporting and Data System: BI-RADS, Mammography. 5th ed. Reston: American College of Radiology, 2013
- Chansakul T et al: The postconservation breast: part 1, Expected imaging findings. AJR Am J Roentgenol. 198(2):321-30, 2012
- Chansakul T et al: The postconservation breast: part 2, Imaging findings of tumor recurrence and other long-term sequelae. AJR Am J Roentgenol. 198(2):331-43, 2012
- Gruber R et al: Histologic work-up of non-palpable breast lesions classified as probably benign at initial mammography and/or ultrasound (BI-RADS category 3). Eur J Radiol. Epub ahead of print, 2012
- Londero V et al: High-risk breast lesions at imaging-guided needle biopsy: usefulness of MRI for treatment decision. AJR Am J Roentgenol. 199(2):W240-50, 2012
- Shaheen R et al: Spectrum of diseases presenting as architectural distortion on mammography: multimodality radiologic imaging with pathologic correlation. Semin Ultrasound CT MR. 32(4):351-62, 2011
- Pediconi F et al: Role of breast MR imaging for predicting malignancy of histologically borderline lesions diagnosed at core needle biopsy: prospective evaluation. Radiology. 257(3):653-61, 2010
- Venkatesan A et al: Positive predictive value of specific mammographic findings according to reader and patient variables. Radiology. 250(3):648-57, 2009
- Günhan-Bilgen I et al: Tubular carcinoma of the breast: mammographic, sonographic, clinical and pathologic findings. Eur J Radiol. 61(1):158-62, 2007
- Cawson JN: Can sonography be used to help differentiate between radial scars and breast cancers? Breast. 14(5):352-9, 2005
- Pediconi F et al: Radial scars of the breast: contrast-enhanced magnetic resonance mammography appearance. Breast J. 11(1):23-8, 2005
- Baker JA et al: Computer-aided detection (CAD) in screening mammography: sensitivity of commercial CAD systems for detecting architectural distortion. AJR Am J Roentgenol. 181(4):1083-8, 2003
- Brenner RJ et al: Percutaneous core needle biopsy of radial scars of the breast: when is excision necessary? AJR Am J Roentgenol. 179(5):1179-84, 2002
- Gajdos C et al: Mammographic appearance of nonpalpable breast cancer reflects pathologic characteristics. Ann Surg. 235(2):246-51, 2002
- Krishnamurthy R et al: Mammographic findings after breast conservation therapy. Radiographics. 19 Spec No:S53-62; quiz S262-3, 1999
- Venta LA et al: Imaging features of focal breast fibrosis: mammographic-pathologic correlation of noncalcified breast lesions. AJR Am J Roentgenol. 173(2):309-16, 1999
